Bluebird Care Ferndown was rated Requires Improvement overall at its first inspection in June 2018, with Safe, Effective and Caring rated Good but Responsive and Well-Led requiring improvement. Key shortfalls centred on non-personalised care plans that failed to capture people's preferences and communication needs, and governance systems where audit tools lacked the ability to record actions, leaving the senior team without robust oversight of care quality.
Concerns (6)
moderateCare planning: “People's care and support plans were not personalised and did not give staff a clear picture of how to support people to meet their assessed needs or reflect their preferences.”
moderateCare planning: “Care plans did not fully reflect people's preferred support needs in relation to information being made accessible to them or how best to support them with communication.”
moderateGovernance: “The audit tools used did not allow the auditors to add details or actions required to improve where necessary.”
moderateGovernance: “quality monitoring and audits of the service were not always shared with them. This meant that the senior team did not always have a robust oversight of practice and care delivery.”
moderateIncident learning: “if care tasks were not completed and a reason given the office was not made aware of these... a mandatory tick box... had been unticked.”
minorRecord keeping: “one person told us that they required staff support to put their hearing aids in however this was not recorded in their care plan.”
Strengths
· Medicines were managed safely, securely stored, correctly recorded and only administered by trained staff.
· Staff had completed safeguarding training and were able to recognise and report abuse; no open safeguarding alerts at time of inspection.
· Staff received regular supervisions, annual appraisals and role-specific training including dementia and nutrition.
· Strong person-centred caring culture with positive observed interactions; compliments recorded from relatives.
· Sufficient staffing levels with no missed visits reported; robust recruitment and DBS checks in place.
Quality-Statement breakdown (21)
safe: Risk assessmentsRequires improvement
safe: Staffing levelsGood
safe: SafeguardingGood
safe: Medication managementGood
safe: RecruitmentGood
effective: Staff training and inductionGood
effective: Supervision and appraisalGood
effective: Consent and Mental Capacity ActGood
effective: Nutrition and hydrationGood
effective: Healthcare accessGood
caring: Dignity, respect and person-centred cultureGood
caring: Promotion of independenceGood
caring: Cultural and spiritual needsGood
responsive: Personalisation of care plansRequires improvement
responsive: Communication and accessible informationRequires improvement
responsive: Care reviewsGood
responsive: Complaints handlingGood
responsive: End of life careGood
well-led: Quality monitoring and governanceRequires improvement
well-led: Leadership and cultureGood
well-led: Community engagement and partnership workingGood
Bluebird Care Ferndown improved from its previous Requires Improvement rating to Good across all five key questions at this August 2019 inspection, demonstrating sustained progress in care planning, governance, and leadership. The sole area for development was end of life care plans, which were found to be brief and lacking in individual detail, though the registered manager committed to addressing this during the inspection.
Concerns (1)
minorEnd-of-life care: “these were brief and did not explore people's individual wishes and preferences. We spoke with the registered manager about this and they made plans to develop these during the inspection.”
Strengths
· Care plans were personalised, improved since last inspection, and met people's needs practically and emotionally.
· Medicines were managed safely with electronic MAR, competency assessments, and audit processes in place.
· Sufficient staffing levels with safe recruitment practices including DBS checks and full employment histories.
· Staff received comprehensive training including safeguarding, medicines, epilepsy, dementia, and basic life support.
· Regular supervisions and competency checks were completed and up to date.
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people, continuous learning and improving care, working in partnership with othersGood